• The Korean Journal of Emergency Medical Services
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• v.23 no.3
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• pp.29-40
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• 2019

Purpose: This study was conducted to identify the effects of educational intervention on pre-test and post-test tidal volume, endotracheal peak pressure, and ventilation interval measurements during single-rescuer respiratory-assistant therapy by paramedic students. Methods: The present study, with a quasi-experimental design, included a pre-test and post-test nonequivalent control group. A total of 62 paramedic students (31, experimental group; 31, control group) participated in this study. The intervention lasted 80 minutes. Data were collected from each student before the intervention and two weeks after the intervention, between September 3 and 21, 2018. The collected data were analyzed using IBM SPSS Statistics for Windows, Version 25.0. Results: Tidal volume (p<.001) and endotracheal peak pressure (p=.002) measurements after the intervention were significantly different between the two groups. Analysis of covariance was used to control the variance (the pretest value of endotracheal peak pressure) in order to identify the effect of the intervention in the two groups. Endotracheal peak pressure was not significantly different between the two groups. Conclusion: Education and training of paramedic students in emergency medical services on single-rescuer respiratory-assistant therapy is necessary for the emergency care of patients with respiratory arrest.

• Journal of Yeungnam Medical Science
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• v.39 no.2
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• pp.98-107
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• 2022

Background: Stroke patients usually experience damage to multiple functions and a long rehabilitation period. Hence, there is a large volume of patient clinical information. It thus takes a long time for clinicians to identify the patient's information and essential pieces of information may be overlooked. To solve this, we stored the essential clinical information of stroke patients in a blockchain and implemented the blockchain technology using the Java programming language. Methods: We created a mini blockchain to store the medical information of patients using the Java programming language. Results: After generating a unique pair of public/private keys for identity verification, a patient's identity is verified by applying the Elliptic Curve Digital Signature Algorithm based on the generated keys. When the identity verification is complete, new medical data are stored in the transaction list and the generated transaction is verified. When verification is completed normally, the block hash value is derived using the transaction value and the hash value of the previous block. The hash value of the previous block is then stored in the generated block to interconnect the blocks. Conclusion: We demonstrated that blockchain can be used to store and deliver the patient information of stroke patients. It may be difficult to directly implement the code that we developed in the medical field, but it can serve as a starting point for the creation of a blockchain system to be used in the field.

• Health Policy and Management
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• v.5 no.2
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• pp.202-229
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• 1995

In Korea, Resource-Based Relative Value Scale(RBRVS) is suggesting to the alternative of Korean Medical Fee Schedule. This study developed to methodology of RBRVS applicable to Korean situation and applied to services of internal medicine and general surgery. Our methodology of RBRVS is basically same to Hsiao's. But there are some differences between our method and H냐매's because Korean medical situation differs to American. The first difference is method of measurement of work. The Unit of work in our study is total work including intra-servic work and pre-/post-service work. Secondly, in extrapolation, we use primary data gathered to small group of physician. Tertially, in measurement of practice cost, we directly survey to budget data of hosptials and analyse practice costs by service. Some results are presented in a companion article.

• Journal of Distribution Science
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• v.16 no.5
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• pp.5-15
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• 2018

Purpose - Nowadays customers have become empowered by information communication technologies. This state of customers has brought enormous pressure to bear on organizations, thus, organizations have to stay relevant, market-oriented and profitable. The insurance sector is one that is constantly challenged by its exposure to ICT and the associated need for e-services by myriad customers. With increasing competition in the health insurance environment, it is necessary for the sector to understand customer expectations and how they perceive the services offered. This study seeks to determine the role played by e-services in relation to customer satisfaction in health insurance industry in Botswana where a substantial investment has been made in the sector. Research design, data, and methodology - This study is conducted using two prominent medical aid schemes in Botswana namely BPOMAS and PULA. Subscribers of these medical schemes were the respondents whose views were sourced using both closed and open ended questionnaires. Systemic sampling technique was used to select the participants, while descriptive statistical techniques were mainly used to analyze socio-demographic data of the samples. Results - The results reveal that the level of usage of the medical insurance firm's website and email service is higher for PULA participants than for BPOMAS participants. Conclusions - The findings of this study have practical implications for managers who should understand customers' value perceptions regarding e-service quality in Botswana.

• Journal of Home Health Care Nursing
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• v.27 no.2
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• pp.198-209
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• 2020

Purpose: This study sought to develop a scale to evaluate patient-centered healthcare services at hospitals and verify its reliability and validity. Methods: We conducted a literature review and interviewed medical personnel and practitioners in medical institutions. We also conducted a content validation and preliminary survey of experts, including 40 preliminary items. We conducted the main survey among 240 medical institution workers to assess the validity and reliability of the preliminary measurement tool. Results: The validity and reliability of the scale were assessed by 29 items underlying six factors: ease of communication, continuity and extension of the hospital's role, stable environment, emotional support, respect for patients' values, and offer of information. Cronbach's α of the whole tool was .91, while the value of each factor ranged from .82 to .74, thereby verifying its reliability. Conclusion: The patient-centered healthcare services scale was identified as a tool appropriate for healthcare professionals. This tool will be useful in a diverse range of research on the development of educational programs for patient-centered healthcare services and the promotion of patient-centered causes.

• The Korean Journal of Emergency Medical Services
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• v.23 no.1
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• pp.165-178
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• 2019

Purpose: This study examined medical college students' perception of euthanasia and analyzed whether there were significant differences in their perceptions based on their grade, religion, and economic situation. Methods: A questionnaire comprising items relating to students' knowledge about euthanasia, their economic situation relationships with patients, and the extent to which euthanasia would be allowed depending on the patient's condition. Results: Results by age and school year revealed there were no statistically significant differences concerning permissible levels of euthanasia. However, differences were found in the permissible levels of euthanasia according to changes in the patients' condition. Conclusion: It can be interpreted that students' personal values and religion had a great effect on the perception of euthanasia than the process of acquiring medical knowledge. The religion or values they have in your life affect your perception of euthanasia more than the process of acquiring and learning medical knowledge. The suffering of patients is the most important priority and it supports euthanasia on the grounds of relieving psychological distress for patients' families and the right of every patient to die gracefully. Nevertheless, considering the possibility of patient survival and euthanasia being used for murder, it is necessary to legislate the use of euthanasia and have the appropriate qualifications for its administration on patients.

• Journal of Korean Academy of Nursing
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• v.39 no.4
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• pp.574-583
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• 2009

Purpose: This paper analyzed alternative methods of calculating the conversion factor for nurse-midwife's delivery services in the national health insurance and estimated the optimal reimbursement level for the services. Methods: A cost accounting model and Sustainable Growth Rate (SGR) model were developed to estimate the conversion factor of Resource-Based Relative Value Scale (RBRVS) for nurse-midwife's services, depending on the scope of revenue considered in financial analysis. The data and sources from the government and the financial statements from nurse-midwife clinics were used in analysis. Results: The cost accounting model and SGR model showed a 17.6-37.9% increase and 19.0-23.6% increase, respectively, in nurse-midwife fee for delivery services in the national health insurance. The SGR model measured an overall trend of medical expenditures rather than an individual financial status of nurse-midwife clinics, and the cost analysis properly estimated the level of reimbursement for nurse-midwife's services. Conclusion: Normal vaginal delivery in nurse-midwife clinics is considered cost-effective in terms of insurance financing. Upon a declining share of health expenditures on midwife clinics, designing a reimbursement strategy for midwife's services could be an opportunity as well as a challenge when it comes to efficient resource allocation.

• The Korean Journal of Emergency Medical Services
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• v.25 no.2
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• pp.7-18
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• 2021

Purpose: This study aimed to present the learning items of indirect practice as an alternative means of ambulance riding practice. Methods: Twelve on-site professionals participated in testing the effectiveness of learning items of utility value in indirect experience practice among the recommended learning objectives of ambulance ride practice using the modified Delphi technique. To validate the learning objectives, the Delphi technique was used to check content validity, and analytic hierarchy process (AHP) analysis was used to analyze the weighting value. Results: As the learning goal of indirect experience practice replaced the ambulance riding practice, four items were derived in consideration of practicality. These items were consistent with the Delphi panel's consistency index, convergence, and agreement. The first learning item to consider was 'Prevention of infection and risk of infection.' Conclusion: The results of this study are meaningful in that they propose the learning items that can achieve the minimum educational goal through indirect experience practice as an alternative means of ambulance training.

• Korea Journal of Hospital Management
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• v.28 no.2
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• pp.21-31
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• 2023

Purposes: Patient experience is a tool to evaluate the process and results of medical services provided by medical institutions from the patient's point of view. Patient satisfaction surveys are a meaningful and essential source of information for improving quality in healthcare organizations. This study aims to provide basic data for improving the quality of medical service that patients can feel by analyzing the recommendation intention and satisfaction of inpatients in specialty hospitals. Methodology: The subjects of this study were 879 inpatients in 28 specialty hospitals in 14 designated fields. We conducted a telephone survey with a structured questionnaire on the satisfaction and recommendation intention for specialty hospitals. Findings: In inpatients, hospital satisfaction was higher in nursing care services and hospital satisfaction was low in physicians care services. The overall patient satisfaction score was 91.4(SD=11.9) out of 100, and the intention of recommendation was 92.0(SD=14.1) out of 100. The factors affecting patient experience were designated fields, sex, age, residential area, monthly household income, and perceived health status. Practical Implications: This study confirmed the high level of patient satisfaction and recommendation intention among inpatients of specialty hospitals. Patient satisfaction can be of great value to healthcare providers in recognizing and improving the quality of care, as well as predicting patients' willingness to revisit medical institutions. This study can be used to improve the quality of hospital care services in specialty hospitals rather than general and tertiary general hospitals.

• Journal of Preventive Medicine and Public Health
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• v.50 no.4
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• pp.217-227
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• 2017

In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.